Abstract
The objective of this study is to determine the in vitro susceptibility of Georgian bacteriophage cocktails on multidrug resistant (MDR) extended-spectrum beta-lactamase producing Escherichia coli (ESBL-EC) isolated from patients’ blood and urine cultures. A total of 615 E. coli isolates were included in this study. Phene Plate (PhP)-typing and phylogenetic grouping were used for the typing. Antimicrobial resistance profiles and ESBL production of all isolates were confirmed according to Clinical and Laboratory Standards Institute (CLSI) criteria. The activities of four bacteriophage cocktails (Enko-phage, SES-bacteriophage, Pyo-bacteriophage, and Intesti-bacteriophage) were determined against 142 ESBL-EC using in vitro spot tests. According to this, Enko-phage were active against 87.3% of the tested strains while that ratio was 81.7% for Intesti-bacteriophage, 81.7% for Pyo-bacteriophage, and 59.2% for SES-bacteriophage cocktails. Based on the contingency tests, the phage cocktails were observed to be statistically significantly (p < 0.001) more effective on ESBL-EC strains belonging to phylogenetic groups D and B2. The employed phage cocktails were found to be affective against all tested resistant types. These results are promising especially for the infections that are caused by MDR pathogens that are difficult to treat. As this is a preliminary step to the potential clinical trials to be designed for the country, in vitro confirmation of their success on a MDR ESBL-EC collection should be accepted as an initial action, which is encouraging to consider clinical trials of phage therapy especially in countries which are not introduce phage therapy.
Highlights
Escherichia coli is the leading bacterial pathogens responsible for intestinal and extraintestinal infections, including urinary tract infections, bacteremia, and meningitis (Kaper et al, 2004)
This study aimed to examine the in vitro activity of Georgian bacteriophage cocktails which are used as part of standard clinical practice in the Republic of Georgia on a well-characterized ESBLEC isolated from Turkish patients’ blood and urine
All 175 extended-spectrum betalactamase producing Escherichia coli (ESBL-EC) isolates were grouped into 20 common types and 122 single types based on typing methods
Summary
Escherichia coli is the leading bacterial pathogens responsible for intestinal and extraintestinal infections, including urinary tract infections, bacteremia, and meningitis (Kaper et al, 2004). Effectiveness of Bacteriophage Cocktails on Clinical ESBL-E. coli. The dissemination of ESBL-EC has become a serious health problem worldwide including Turkey (Pitout and Laupland, 2008; Rodriguez-Bano and Pascual, 2008; Tasbakan-Isikgoz et al, 2011; Hawser et al, 2012). ESBL producing pathogens are known to be resistant first, second, and third generation cephalosporins and monobactams, and to several other classes of antibiotics. The upcoming threat of increase in the prevalence of untreatable infections has motivated the quest for alternatives of antibiotic therapy
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